Title: Assessment and Intervention for Emerging Language
1Assessment and Intervention for Emerging Language
- Paul R. (2001). Language Disorders from Infancy
through adolescence. Chapter 8
2What is emerging language stage (EL)?
- For normally developing children, corresponds to
toddler age range - Approx - 18 - 36 months
3Who might be at the EL stage?
- Children between 18-36 mos with no known risks
but parents or others are concerned - Children between 18-36 mos with known risks
- Older children with severe disabilities
4To see them or not to see themthat is the
question.
- Children under 3 with intact cognitive, preverbal
communicative, and sensory capacities with no
risk factors - low priority - Children with cognitive deficits, hearing
impairment or chronic OM, preverbal communication
problems, risks pre or perinatally - should be
seen
5But remember...
- Therapy may facilitate development in normal
slow talkers - Children with later language disabilities often
have histories of delayed language development
6Normal Development
7Assessment of Communication in EL
- Multidisciplinary and Transdisciplinary
assessment - Play assessment
- Communication assessment
8Play Assessment
- Want to ensure child is at a developmental level
consistent with communication development - Relationships exist between play and language
development - Provides a more holistic picture of the child
9Assessing Play
- Communication and Symbolic Behavior Scales
(Wetherby Prizant, 1990) - Play Scale (Carpenter, 1987)
- parent plays with the child
- see Table 8-1, 8-2 p 251
- McCune (1985)
- child is given a set of toys and behaviours are
analysed (see Table 8-2) - Symbolic Play Test (Lowe Costello, 76)
10Communication Assessment
- Rating Scales
- see Table 8-3, p. 253-254
- Communication and Symbolic Behavior Scales
(Wetherby Prizant, 1990) - observe parent and child in various interactions
- rates performance in five areas
- Informal examination of communication functioning
11Informal Examination of Communication Function
- Assessing Communicative Intention
- Assessing comprehension
- Assessing Production
12Assessing Communicative Intention
- Range of communicative functions
- Proto-imperatives
- Requests for objects
- Requests for actions
- Rejections or protests
- Proto-declaratives
- Discourse functions
- Requests for Information
- Acknowledgements
- Answers
13Assessing Communicative Intention (contd)
- Frequency of expression of intentions
- Forms of communication (e.g. gestural, vocal)
14Assessing Communicative Intent Worksheet
- Table 8-4, page 256
- Communicative Act
- Must be directed at adult. Child must look at or
address the adult directly in some way. - Must have an effect on influencing the adults
behaviour/focus of attn or knowledge. - Child must be persistent in the attempt to convey
the message if the adult does not respond
15Assessing Comprehension
- Standardized language tests/scales
- PPVT-III, Sequenced Inventory of Communicative
Development (SICD), Receptive Expressive Emergent
Lang Scale (REEL).
16Comprehension ActivitiesUnderstanding Single
Words
- A collection of six to eight items
- Give me or Wheres
- Can assess body parts
- Assess verbs
- Comprehension of single words is normal for 12-18
mos. - What if they dont?
17Comprehension activities Two word combs
(18-24m)
- Action-object (use words understood at
single-word stage) - choose unusual combinations such as kiss the
apple hug the shoe
18Comprehension ActivitiesBeyond 2-words (24-36 m)
- Agent-action-object instructions
- Rely on probability
- Start with vocabulary from earlier stages and
then move on - see Table 8-6
19Comprehension beyond 36 months
- Can be tested using formal comprehension measures
such as PPVT-III, TACL-R, Miller-Yoder Test of
Grammatical Comprehension, CELF-P
20Comprehension FindingsWhat do they mean?
- If comprehension is superior to production
- better outcomes
- If comprehension is poor
- need to include comprehension component in
therapy as well as expressive component
21Assessing Espressive Language
- Speech motor development
- Speech sample/phonetic repertoire
- Phonological skills
- Lexical production/Vocabulary
- Semantic-syntactic production
22Vocabulary (Lexical Production)
- Expect a child to have at least 50 words and some
two-word combinations in the 24-36 month stage - Rating scales
- MacArthur Communicative Development Inventories
(Fenson et al., 1993) - Language Development Survey (Rescorla, 1989)
23Semantic syntacticproduction
- Children dont begin to combine words until
vocabulary size is approx 50 words - To assess semantic-syntactic production
- Determine the relative frequency of word
combinations - Evaluate semantic relations expressed
- Table 8-7 (Browns Semantic Relations)
- Variety of relations
- Advanced relations
- Normal toddlers express 8-11 different semantic
relations
24Decision making based on assessment information
- See Pauls decision tree on p. 253 (Fig. 8.2)
25Intervention Goals, Procedures Context
- Four main areas that may be targeted
- Functional and symbolic play skills
- Using intentional communication
- Language comprehension
- Production of sounds, words, and word combinations
26Functional and Symbolic Play Skills
- Step1 Establish reciprocal behaviour and
anticipatory sets (e.g. peek-a-boo) - Step 2 Model early forms of symbolic play and
encourage imitation - Step 3 Model play routines like pretending to
give the doll a bath, meal time, store games
27Developing Intentional Communicative Behaviours
- Want children to initiate communication
- 1 Communication temptations
- can model first with the parents (e.g. hand Mum a
container and she hands it back to therapist and
indicates take the lid off or says help.
Then hand container to the child) - 2 Milieu model
- place things out of reach and get the child to
ask for it or draw the childs attention to it
and wait for a response
28Developing Intentional Communication (contd)
- 3 Use routines or script therapy and then
violate the routines - 4 Respond as though the child is showing
intent - 5 If range of intent is limited, increase use
of proto-imperatives and declaratives - model the behaviour
- pretend not to notice something that the child is
interested in and wait for them to get your
attention
29Developing Intentional Communication (contd)
- If child has adequate intentions but is only
using gesture --gtincrease vocalising - Model the target response
- Withold response or pretend not to notice until
some vocal behaviour produced
30Developing Intentional Communication (contd)
- If the child is using maladaptive behaviour
- immediately provide an alternative form of
communication (e.g. I see you want it. Point to
it and Ill give it to you.) - might need to actually take the childs hands and
demonstrate the action
31Developing Receptive Language
- Indirect Language Stimulation (parent training)
- self-talk/parallel talk
- imitations
- expansions
- extentions
- build-ups and breakdowns
- recast sentences
- labelling
- see box 8-3
32Developing sounds, words, and word combinations
- Increasing phonological skills
- expand the repertoire of sounds
- use developmental information
- Developing a first lexicon
- choose words based on normative data
- some words should be nouns for labeling
- other words should be chosen for expressing other
functions - see Table 8-10
33Developing sounds, words, and word combos (contd)
- Developing a first lexicon (contd)
- MacDonald suggested choosing words that are
within the childs interests - Consider the childs phonetic repertoire
- choose words with sounds in the childs
repertoire - early words may be limited to CV and CVC shapes
34How should we teach first words?
- Child centered approach
- clinician provides many models
- use play contexts and dont require response
- Hybrid approach
- milieu teaching
- place objects out of childs reach
- script therapy
- engage in a verbal routine, once it is
overlearned, either violate it or use a cloze
technique
35How should we teach first words?
- Hybrid approaches
- focussed stimulation
- set up the situation so that you are modeling the
specific vocabulary you want to teach - provide lots of opportunities for the child to
produce it - use recasts, expansions, extensions, etc.
- Clinician-directed
- may be suitable for older children
36Developing word combinations
- Word combinations express semantic relationships
- Client-centered
- play situation-when the child produces a one-word
utterance, the clinician expands it to a two-word
phrase
37Developing word combinations
- Hybrid approaches
- Schwartz et al.(85) - vertical structuring
- Whitehurst et al.(91) - see box 8-5
- milieu approaches
- put something out of childs reach - get X
- focussed stimulation
- script therapy
- perhaps use a book or song-play that has two words
38Developing word combinations (contd)
- Clinician-directed approaches
- Leonard (75)
- use a puppet and the puppet describes whats
happening in the picture - get the child to tell the puppet whats
happening and to talk like the puppet - MacDonald et al. (74) - Environmental Language
Intervention (ELI) - parent works on goal for 5 min in 3 conditions
- sessions are three times/week
- see Box 8-6
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